SPAIN-FRANCE-ANDORRA TERRITORIAL
COOPERATION PROGRAMME 2007-2013
A CROSS BORDER MANAGING AUTHORITY
The Pyrenees Working Community
Planning together in cross border territories
Meeting of the EGTC Approval Authorities
Budapest, 22nd of february 2013
Introduction
 The Pyrenees Working Community manages the
current Spain-France-Andorra ETC programme:
 It is a Consortium: a cross-border organization which
represents the 7 regions of the border plus Andorra.
 The Consortium is an entity which was created by the
franco-Spanish Bayonne Treaty in 1995.
 This franco-spanish legal framework for the
Consortium is quite similar to EU Regulation through
EGTC
 The ETC programme finances the project of the cross
border Hospital with a 65% ERDF contribution
Zones Éligibles du Programme Interreg IV A
France-Espagne 2007-2013
Tarn-et -G aron ne
Lan des
Tarn
Ge rs
Hau te-G aro nne
Pyréné es-A tla ntiqu es
Bizkaia
Au de
Gipuzkoa
Hau tes-P yrén ée s
Ariège
Alava
Andor ra
Nav ar ra
Pyréné es-O rie nta le s
Hue sca
La Rioja
Lle id a
Giron a
Ba rce lo na
Zarag oza
Zone É ligible
Tarrago na
Zone de Co ntigü ité
Zone É ligible h ors UE
SPAIN-FRANCE-ANDORRA TERRITORIAL
COOPERATION PROGRAMME 2007-2013
THE CROSS BORDER HOSPITAL OF CERDANYA
The EGTC of the Hospital of Cerdanya
Planning together in cross border territories
Meeting of the EGTC Approval Authorities
Budapest, 22nd of february 2013
CERDANYA /CERDAGNE
PARIS
MONTPELLIER
MADRID
BARCELONA
BASIC DATA ABOUT THE TERRITORY OF CERDANYA
Territory with common history and culture (Language)
30.000 inhabitants. Touristic peaks of 150.000
2 EU members
2 Health Administrations, with different health Systems and health care
organizations.
Asymmetric competences (Central Government – Regional Government)
Asymmetric health care offer:
• South: Local Hospital of Puigcerdà:
• North: Long care, rehabilitation
• Different PHC approach
Same health needs for population:
•
•
•
Improve access to health care
Assure permanent and continuous care
Quality and security assurance.
Montpellier
Toulouse
Distance and time to get to the
current Hospitals from Puigcerda to
Perpignan
Prades
Puigcerdà
Berga
Manresa
Sabadell
Prades
60 Km.
1h 15’
Perpignan
105 Km.
2h 05’
Montpellier
257 Km.
3h 35’
Toulouse
171 Km.
2h 15’
Berga
60 Km.
55’
Manresa
99 Km.
1h 25’
Sabadell
135 Km.
1h 55’
Barcelona
150 Km.
2h 15’
Barcelona
© 2009 Google Maps. © 2009 TerraMetrics. © 2009 Tele Atlas.
1997. Professional
Cooperation.
2002. Services of
the Puigcerdà
hospital for the
Cerdanya
(Emergencies and
delivery).
2003. Feasibility of
Crossborder
Common Hospital
Cerdanya
2006. Hospital in
both health network
INSTITUTIONAL CONCEPTION
Consortium
Bayonne treaty ?
2006. Private
Foundation Catalan
law
2008 EGTC
Works Bid
Comanagement and executive board
PROJECT OBJECTIVES
1.
To create a common hospital which should be the main axis of
a network of cross border health services regarding the rights
and duties of the citizens in the two states
2.
To create a cross border organization for the construction and
management of a hospital for acute patients which should
attend to the needs/services of all the population in Cerdanya
and Capcir.
3.
To set up an organization based on a sole culture which
should integrate the advantages of the two health systems.
4.
To guarantee a single and participative Governance. A single
management approach too and a single health service’s
provision model.
5.
A hospital established in a single territory where both health
planning systems have been taken into account.
MAIN ISSUES
A.
Differences regarding tools, rhythms and different administrations
policies
(local,
regional,
national,
European).
Various
administrations different degrees of political decentralization.
B.
Difficulties
to
identify
the
corresponding
counterparts.
Communication problems between administrations. Coordination
difficulties.
C.
Project with a strong ideological component (European
construction) tied to political events. (local, regional, national and
European constitutional elections)
D.
Difficulties in recruiting professionals and in addressing general
public directly. Difficulties in responding to expectancy in real
time.
E.
Difficulties to coordinate the actors (local, regional, national)
F.
Difficulties in solving certain issues: free movement for patients,
expenditure
reimbursement,
quality
guarantee,
workers
professional certification
Legal steps
 Transitory Foundation . Governance decisions
 60% Catalunya
 40% France
 Participation of local governments
 Decision process
 Legal adaptation Spain (02/2008) France
(04/2008)
 France – Spain Health Agreement (09/2008)
 EGTC Legal set up (2008-2009)
 EGTC approval by both states (2010)
The EGTC HC organization
 Presidency: it changes every 2 years between
the French State and the Catalunya Region. It
has a representation role.
 General Director: he is charge of the EGTC
management
 Executive board: It gathers representatives of
the EGTC members. It takes the key decisions
about the way the EGTC has to be run.
 Advisory Committee: Representation of local
governments from the territory of Cerdanya. It
advises the Executive board on its tasks.
The EGTC HC organization
Executive Board (14 members)
8 members from the Catalan part
6 members from the French part
6 representatives of the Spanish
Ministry of health
4 representatives
of the French
Republic Government
1 representative of the catalan health
service
1 representative of the Regional Health
Agency of the Languedoc-Roussillon
region
1 representative of the Spanish
Government
1 representative from the French Social
Security
Advisory Committee (14 members)
Action Plan
 Executive Construction project of the
Hospital: bid announcement in September
1st of 2008)
 Construction works ending in 2012
 Opening of the Hospital in 2013
 Implementation Plan of the cross border
hospital
The hospital construction
 A 31 million euros budget: 18,6 million of ERDF
contribution through the Spain France Andorra
Territorial Cooperation Programme 2007-2013
 Main feature of the forthcoming offer in the
Hospital:
 32 bedrooms and 64 beds
 Main services: surgery (very complete offer), cardiology,
pediatrics, dermatology, emergency, complete imaging
department
 200 people will work for the hospital
The cross border hospital
implementation plan
 Main objectives
To respond to the needs of people from
both sides of the border
To facilitate the access to the health care
system for people living next to the border
and far from the big cities like Barcelona or
Perpignan
To look for complementarity between
health services of both countries
The cross border hospital
implementation plan
 Main solutions through cooperation
 Both Social Security systems will work in this hospital
thanks to an agreement between both states which
will allow to take charge of the French and Spanish
patients on both sides of the border. This agreement
will be approved very soon.
 As regards medical prescriptions, given that the
patient will have to find the right medicine in his own
country, the doctors will write down the components
of the medicine and not the mark/brand.
The cross border hospital
implementation plan
 Main solutions through cooperation
 Unique organization to respond to emergencies: both
emergency services from both countries will work
altogether and will have the capacity to intervene on
both sides of the border thanks to a cooperation
convention between Catalunya and France.
 The administrative burden for parents of French
babies born in Spain (in the hospital) will be made
easier thanks to a specific staff in charge of this task.
Moreover, these babies could have the opportunity to
have the double nationality.
The cross border hospital
implementation plan
 Main solutions through cooperation
 The medical staff will not be employed directly by the
EGTC: a specific convention will be signed between the
EGTC and other health services of the region in order
to send part of its staff to the new cross border
hospital (until EU Regulation improves on this subject)
 The other services of the hospital (communication,
security,
gardening,
housekeeping,
laundering,
cooking, computer service) will be externalized to
french partner private or public companies through
different bid announcements
The cross border hospital
implementation plan
 Main solutions through cooperation
 For French people, the overcost (due to lead-covered
coffins) of dead bodies transferred to France will be
paid by French Social Security (at least until a better
solution is found).
 The French State is currently working on an
international convention between both states in order
to avoid additionnal costs for bodies transferred to
France for the specific case of the cross border
Hospital.
THANK YOU VERY MUCH